ABSTRACT
Objective To explore the value of static and dynamic MRI before and after operation of pelvic organ prolapse (POP). Methods 29 patients with POP (POP group)and 12 normal women (control group)underwent static and dynamic MRI.The morphologic changes of pelvic floor were observed on MR images.The measurements of bladder,uterus,Douglas pouch to pubococcygeal line (B-PCL,U-PCL,D-PCL),the puborectal hiatus line (H-line),muscular pelvic floor descent (M-line),the levator hiatus size (LHS),the levator plate angle (LPA),the iliococcygeus angle (ICA)and the urethral inclination angle (UA)were recorded on dynamic MR images.Results 19 cystoceles,28 uterine prolapses,4 rectoceles and 14 hernias of Douglas pouch were detected with MRI.29 cases of pelvic floor relaxation,27 cases of levator ani muscle defect and 24 cases of pubocervical fascial defect were found.The values of B-PCL,U-PCL, D-PCL,H-line,M-line,LHS,LPA,ICA and UA of POP group were larger than control group (P<0.01).The positions of pelvic organ returned to normal in 9 cases of 21 postoperative cases,while 12 cases remained prolapses.There was no displacement of mesh in 8 cases of mesh implant.The values of B-PCL,U-PCL,D-PCL,UA after operation were smaller than those before operation (P<0.05).Conclusion Static and dynamic MRI can evaluate morphological and functional changes of pelvic floor before and after operation of POP comprehensively,and may reveal those invisible pelvic floor dysfunction and postoperative remnant defects.
ABSTRACT
Objective To explore the MRI findings of ovarian cancer peritoneal carcinomatosis (PC).Methods MRI findings of 34 cases with advanced ovarian cancer and PC confirmed by operation and pathology were reviewed retrospectively.MRI protocols included T1 WI,T2 WI,MRH,DWIBS,and gadolinium-enhanced 3D THRIVE sequences.The type of ovarian tumor and MRI manifestations of PC were analyzed.Results All of the ovarian tumors and PC lesions were high signal intensity in DWIBS.All of the ovarian tumors were shown as mixed cystic solid masses,including type Ⅱa in 12 cases,type Ⅱb in 7 cases,and type Ⅱc in 1 5 cases.The MR manifestations of PC were described as follow:linear thickening of the peritoneum (n=2),irregular linear thickening of the peritoneum (n=27);smudged thickening of the omentum (n=1 9),cake-like thickening of the omentum (n=1 1);fouling-appearance of the mesentery (n=4);plaque,nodule and mass in the abdominal cavity (n= 34),cystic mass (n=8).PC lesions were detected in the Douglas’space in 31 cases,paravesical interspace in 24 cases,omentum in 20 cases,paracolic gutter in 9 cases, right subdiaphragmatic / parahepatic space in 1 1 cases,and left subdiaphragmatic / parasplenic space in 10 cases.The primary and PC tumors invaded the rectum in 26 cases,sigmoid in 22 cases,and uterus in 1 6 cases.Ascites and lymphadenectasis in abdomen were seen in 33 and 7 cases,respectively.Conclusion Ovarian cancer PC can be diagnosed accurately by combing DWIBS and con-ventional MRI.